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When deciding commands, baseball coaches observe the current situation from various viewpoints, think of various criteria, and select commands/eliminate inappropriate commands. Whether they can arrive at the appropriate commands depends on the range of viewpoints and the number of criteria and commands that they consider. Usually, this process of deciding commands cannot be evaluated, since it is done in the mind and is not observed. The objective of this research is to develop a system by which a baseball coach's ability to decide on an appropriate command is improved by providing an environment for externalizing the decision process. In addition, a function for comparing the represented decision process with that of others is provided in order to allow the baseball coach to notice other effective decision processes previously unconsidered.

This paper summarizes the results of an investigation on the viewing angle requirements for large flat-panel television displays as well as on screen tilting as a means of reducing glare in accordance with the “Ergonomic Design Guidelines for Flat Panel Display Televisions” established by a special committee of the Japan Ergonomics Society. First, taking into account screen size, we investigated viewing angle requirements through a field survey of household television viewing conditions. We then evaluated the influence of the size, mounting height, and tilt of the screen on the occurrence of glare. Next, we conducted laboratory experiments to investigate the allowable tilt angle for ensuring acceptable viewing comfort and the optimum screen tilt angle for each mounting height. The results can be used as guidelines for adjusting viewing conditions as well as for ergonomic design of flat-panel television displays.

The preferred luminance level of LCD televisions under actual viewing conditions is important to obtain both good picture quality and low power consumption. We investigated actual viewing conditions of households and preferred luminance levels. As a result, we obtained equations which represent the preferred luminance level corresponding to different viewing conditions.

The preferred viewing distances for high definition television LCDs were measured as a function of the screen size, screen luminance and content of the displayed pictures. Although the screen size is the most dominant parameter, both it and the screen luminance significantly influence the preferred viewing distance, while the content of the displayed pictures does not. The ratio of the viewing distance preferences to the screen height (H) decreases with the size of the screen. The preferred viewing distance for a 24-inch display is a 5.9 H for a screen luminance (peak white luminance) of 200cd/m2. Similarly, that for a 65-inch display is a 3.9 H. The preferred viewing distance for a screen luminance of 200cd/m2 can be described Using the following empirical equation: D = (2.73 S + 75) /S. This is where D is the preferred viewing distance in screen height and S is the diagonal screen size in inches, where S is larger than or equal to 24 and smaller than or equal to 65. In this paper, these results are compared with the field survey data of the practical viewing distances in home environments. We also discuss the optimum screen size and viewing conditions of high definition television LCDs in actual home environments.

We succeeded to develop a reference light source in the range of very low luminance using a double integrating sphere system, and calibrated a commercial spectrophotometer below 1 × 10-5cd/m2 levels, which is 1/100 lower than the specified limit for measurement. And we improved measurements in the ultra low luminance range of displays using the calibrated commercial spectrophotometer and a dark sphere to suppress the influence of the surround.

The color gamut of xvYCC is wider than that of film. We evaluated the color reproduction and developed a new method of converting the video signal, which reproduced color of a film in xvYCC color space faithfully.

【背景と目的】肝細胞癌における性別の臨床疫学的特徴を明らかにするため過去10年間に診断された263例について検討した, 【方法】発症年齢, 飲酒歴, 肝炎ウイルス, 臨床病期, 腫瘍数 最大腫瘍径, 門脈侵襲の程度, 肉眼的進行程度, 予後について性別による差があるか統計学的に検討した.【結果】内訳は男性189例, 女性74例で, 年度別でも男性 (18.9人/年) が有意に女性 (7.4/年) より多く, 発症年齢 (62.9 : 66.9歳) も若かった.この差はHCV陽性者においても有意であった.男性では飲酒率, HBV陽性率, 進行度が女性と較べ高く, 腫瘍数 門脈侵襲も有意に多かった.肝予備能には差はなく, 予後については男性に早期死亡が多い傾向がみられたが早期に発見され肝切除された症例では差はなかった.【結論】肝細胞癌では男性が女性の約25倍多く, その背景には複数の因子が癌発生から進展に至るまで影響を及ぼしており, 今後肝癌に対しては性差を考慮した診療が必要と考えられる.

We evaluated the synergistic effect of zinc supplementation on the response to interferon (IFN) therapy in patients with intractable chronic hepatitis C in a pilot study using natural IFN-alpha with or without zinc. No clinical differences were observed between patients treated with IFN alone (n=40) and IFN with polaprezinc (IFN + Zn, n=35). All patients were positive for HCV genotype Ib and had more than 105 copies of the virus/mL serum. Ten million units of natural IFN-alpha was administered daily for 4 weeks followed by the same dose every other day for 20 weeks. In the IFN + Zn group, patients received an additional dose of 150 mg/day polaprezinc orally throughout the 24-week IFN course. No additional side-effects of polaprezinc were noted but four out of 40 IFN alone treatment and three out of 35 IFN + Zn group withdrew because of side-effects. Complete response (CR) was defined as negative HCV RNA in the serum on PCR and normal aminotransferase level 6 months after therapy. Incomplete response (IR) was normal liver enzyme and positive serum HCV RNA. Both of them were evaluated at the 6 months after the completion of the treatment. Patients with higher levels of serum HCV (more than 5 x 105 copies/mL) had little response in both treatment groups. Patients with moderate amount of HCV (105 to 4.99 x 105/mL) showed high response rates in combination group (CR: 11/27, 40.7%; CR + IR 15/27, 64.3%), better than IFN alone (CR: 2/15, 18.2%; CR + IR: 2/15, 18.2%). Serum zinc levels were higher in patients with IFN + Zn group than in the IFN group. Our results indicate that zinc supplementation enhances the response to interferon therapy in patients with intractable chronic hepatitis C.

症例は66歳, 男性.1993年3月 (60歳時), C型慢性肝炎CH (F3/A2) のため, インターフェロン (IFN) 療法を受けた.HCV-RNAは持続的に陰性となり, 血清ALT値は正常化し, 著効と判断した.1999年10月に血清PIVKA-II値が上昇し, 腹部CT検査で肝S4に約2cmの腫瘤を認め, 肝細胞癌 (HCC) の診断で, 経カテーテル的肝動脈塞栓療法後に手術を施行した.病理学的には, 癌部は偽腺管型の中分化型HCCであった.非癌部には, 線維性架橋の形成を認めるが, 壊死・炎症所見は軽度でCH (F2/A1) と判断した.IFN療法著効例においてHCCを認めた場合, 非癌部は肝硬変に陥っていることが少なく, 肝機能も比較的良好なことから血液検査や画像検査を3～6ヶ月ごとに行い早期にHCCを発見し治療することが重要である.

AIMS/BACKGROUND: Sex difference has been shown to play a major role in susceptibility to the development of hepatocellular carcinoma in humans and rodents. In order to clarify the necessity of androgens in hepatic tumorigenesis in transgenic mice overexpressing transforming growth factor (TGF) alpha (MT42), androgen supplement after castration and the LH-RH analogue, leuprolerin acetate, were tested in an experimental model in MT42. METHODS: Male MT42 mice were castrated and supplemented with dihydrotestosterone (DHT) every three months up to 15 months and hepatic tumorigenesis was observed. Leuprolerin acetate was administered to both male and female MT42 mice once a month from 2 months after birth to 15 months to observe the effect on hepatic tumorigenesis. Northern hybridization was performed to detect messenger RNA (mRNA) of TGFalpha expression and the rate of proliferative cell nuclear antigen (PCNA) staining compared with the castrated and non-treated mice. RESULTS: Castration tended to decrease both body and liver weight in MT42 mice which was then restored by DHT. Untreated MT42 males developed 11 liver tumors in 6 mice. Hormonal treatment including castration and DHT supplementation did not change the expression of TGFalpha-mRNA. Castrated transgenic mice developed 2 liver tumors in 2 out of 6 mice and DHT supplementation after castration restored the number of liver tumors to 9 in 5 of 6 mice. PCNA labelling indexes of liver tumors and adjacent non-tumorous-liver were 7.1% (p

症例は72歳, 女性. 左頚部リンパ節腫脹で発症した孤立性肝結核腫の治癒過程を各種画像所見を中心に報告する. US, CT, 血管造影にて肝左葉内側区域に径5cmの腫瘤を認めた. MRIではT1強調画像で低信号, T2強調画像で高信号として認められ, Gd-DTPA静注で辺縁 および内部の網目状の隔壁が濃染された. 胸部および大腸に病変は認めず, 左頚部リンパ節生検および肝生検を施行し, 両組織において結核菌が確認された. 抗結核薬投与にて諸症状は改善し, 1年後には腫瘤の著明な縮小がみられた. MRIで治療前に高信号を示していたT2強調画像では, 等信号に変わっていた. 孤立性肝結核腫は比較的まれな疾患であり, そのMRI所見の報告はきわめて少ない. 病期によって異なると考えられてきた孤立性肝結核腫のMRI所見が実際に確認されたので, 興味深い症例と考え報告した.

Clinical, pathological, and virological analysisincluding hypervariable region-1 of hepatitis C virus(HCV) was performed to predict the effect of interferon(IFN) on 41 patients with chronic hepatitis type C. The low virus load, low frequency ofthe mutation in the hypervariable region-1 as the changeof amino acid and high level of serum aminotransferasemake one estimate the good effect of IFN on patients with HCV. Mutation in the hypervariableregion-1 of HCV measured by fast assay fluorescencesingle-stranded conformational polymorphism was morefrequent in nonresponders to IFN than responders. Themost frequently mutated position was amino acidnumber 406. This indicates that the specific mutationsite might affect the response of IFN.

The effects of enalapril on exercise capacity and neurohumoral factors during exercise were evaluated in 10 patients with heart failure. Echocardiograms and exercise testing with expired gas analysis were performed before and after enalapril. Blood samples were obtained before and after exercise. Both ejection fraction and percent fractional shortening increased with enalapril (p0.05). The anaerobic threshold and peak VO2 did not change with enalapril. Epinephrine and norepinephrine levels at peak exercise decreased with enalapril (p0.1). Plasma renin both at rest and at peak exercise increased with enalapril (p0.1). Angiotensin II was lower after enalapril both at rest and at peak exercise (p0.1 and p0.05, respectively). Aldosterone was lower after enalapril both at rest and at peak exercise (p0.05). Atrial natriuretic peptide (ANP) was lower after enalapril both at rest and at peak exercise. There was no significant correlations between peak VO2 and changes in neurohumoral factors before and after enalapril during exercise. In conclusion, neurohumoral changes with enalapril occurred during exercise even if exercise capacity did not improve. Moreover, the improvement of cardiac function at rest and neurohumoral factors with enalapril did not lead to a change of exercise capacity.

OBJECTIVE: To assess energy depletion in skeletal muscle in patients with congestive heart failure by measuring blood purine metabolites during exercise and, at the same time, determine the implications of the ammonia response to exercise in these patients. SETTING: Tottori University Hospital, Yonago, Japan. PATIENTS: 49 heart failure patients (New York Heart Association (NYHA) grades I-III) and 16 normal subjects. MAIN OUTCOME MEASURES: Blood lactate, ammonia, and hypoxanthine levels were measured during exercise with expired gas analysis. RESULTS: In normal exercising subjects as well as in each heart failure subgroup, the ammonia threshold was significantly higher than both the lactate threshold [control: 21.8 (SD 5.3) v 17.4 (3.3) ml/kg/min; NYHA class I: 18.9 (3.8) v 15.5 (2.6); class II: 14.8 (2.5) v 12.7 (2.4); class III: 13.5 (2.6) v 11.8 (2.5)] and the ventilatory threshold (P < 0.01). The difference between the ammonia and lactate thresholds was noted in all normal subjects and in all heart failure patients. The ammonia threshold, however, was significantly lower in heart failure patients than in normal subjects and it decreased with increasing NYHA class (P < 0.01). Maximum ammonia levels were lower in the heart failure group and decreased further with higher NYHA classifications [control: 198 (52) mg/dl; NYHA class I: 170 (74); class II: 134 (58); class III: 72 (15); P < 0.01]. There were significant correlations between maximum ammonia values and maximum lactate, oxygen consumption, and hypoxanthine levels (r = 0.74, 0.48, and 0.87, respectively; P < 0.001). CONCLUSIONS: The ammonia threshold may reflect the onset of ATP depletion in exercising skeletal muscles, as opposed to the onset of anaerobic respiration. It seems therefore that energy depletion in skeletal muscles during exercise occurs after attaining the anaerobic threshold. Both aerobic and anaerobic capacities of skeletal muscle are reduced in patients with congestive heart failure.

KCI single crystal fragments are obtained in natural cleavage forms by rapid cooling of the melt. Several features of the various macroscopic defects in the above fragments are summarized as follows: (i) The step lines (stepwise striations) can be observed on the cleaved surface. The propagation and the formation of these lines are discussed in relation to different macroscopic defects in the crystal. (ii) Micro-grain structures were observed in the subgrain of the crystal. The crystal was compressed and the migration or deformation of the micro-grain was observed even under a very weak compression below the yielding stress. (iii) The distribution of the crystal edge d depends on the cooling velocity v as dt 1/v 2 , in the crucibles are of some systematic one. (iv) The distribution of impurity concentration does not fit to the simple segregation rule, but some modification in the crystal growth direction might explain these results. In particular, it is known that the impurity density is low locally in the region in which the crystal grows in a high growth rate direction of the crystal. Further the macroscopic features are proved to be related to the microscopic ones.

We studied the causes of exercise-induced ST-segment elevation. Group I consisted of 15 patients with anterior myocardial infarction in the absence of a coronary artery luminal narrowing of 75% or more. Group II consisted of 36 patients with predominantly exertional angina and a luminal narrowing of 90% or more in the left anterior descending coronary artery in the absence of previous myocardial infarction. In group I, exercise-induced ST-segment elevation occurred frequently during treadmill exercise (15/15, 100%). None of the patients showed 201Tl redistribution. The standard deviation of the phase in radionuclide ventriculography increased during bicycle exercise. Of group II patients, only those with 99% narrowing and poor collaterals showed exercise-induced ST-segment elevation (13/14, 93%), whereas none of those with complete occlusion or 99% narrowing and good collaterals, or 90% narrowing showed ST-segment elevation. In group II, patients with exercise-induced ST-segment elevation showed lower 201Tl uptake during exercise and washout in the territory of the diseased vessel than those without exercise-induced ST-segment elevation. In conclusion, wall motion abnormalities may cause exercise-induced ST-segment elevation independently of myocardial ischemia. In patients with predominantly exertional angina, exercise-induced ST-segment elevation may be a marker for 99% narrowing with poor collaterals and severe myocardial ischemia.

The therapeutic effect of transcatheter arterial chemoembolization (TAE) performed on 31 patients with primary liver cancer was evaluated using the following procedures: (1) the alpha-fetoprotein (AFP) reduction rates and prognoses were analyzed according to the tumor reduction rates (TR), and (2) the AFP reduction rates and prognoses were also analyzed according to the tumor necrosis rates (TN) estimated by regarding every region with Lipiodol retention as being necrotic. The following results were obtained. The AFP level was 400 ng/ml or higher in 15 patients (48%). Their AFP reduction rates were as favorably high as 65.4%-99.8% (mean, 88.1%), and the AFP level was normalized in 3 patients. The cumulative survival rates after the initial treatment were relatively high, i.e., 78.4% in the 1st year, 58.1% in the 2nd year, and 38.7% in the 3rd year. These results suggested the effectiveness of the TAE treatment undertaken in this study. Regarding the TR, the tumor was reduced in size by 50% or more in only 5 patients (16%), and most patients had a TR of less than 25%. On the other hand, the majority, 25 patients (81%), had a TN ranging between 50% and less than 100%, including 7 who had a TN ranging between 50% and less than 90% and 18 who had a TN ranging between 90% and less than 100%. There was no significant correlation between the AFP reduction rate and the TN or TR. Regarding evaluation of the cumulative survival rates by TR and TN, the 1-year survival rate was lower in patients having a TR of less than 25% than in those having a TR of 25% or more. Patients having a TN of less than 50% showed a poor outcome as compared with those having a TN of 50% or more. Although the TR was found to be less than 50% in a majority of the patients when the therapeutic effect of TAE on the liver cancer was evaluated according to the TR, many of these patients showed a good outcome. Thus, the conventional efficacy evaluation, in which a tumor reduction of 50% or more is considered to be effective, should be reconsidered. On the other hand, the TN was found to be 50% or more in most of the patients, suggesting the necessity of a more detailed classification of TN. In relation to the survival rate, patients having a TN of less than 50% showed a poor outcome.

1. 1. The relationship between the negative inotropic and chronotropic effects of tocainide and 5 other class I antiarrhythmic drugs was evaluated in Langendorff-perfused guinea-pig hearts. 2. 2. All 6 drugs reduced the contractile force (Fc) and the heart rate (HR) of spontaneously beating guinea-pig hearts in a dose-dependent manner. The order of crude negative inotropic potency was: quinidine (Qui) = aprindine (Apr) > mexiletine (Mex) > lidocaine (Lid) > disopyramide (Dis) > tocainide (Toc); and the order of negative chronotropic effect was: Apr > Qui > Mex > Dis > Lid > Toc. 3. 3. The order of the negative inotropic potency relative to chronotropic effect (expressed as a ratio: ID 50 for Fc/ID 50 for HR) was Lid > Qui > Dis > Toc > Mex > Apr ( n = 6). 4. 4. For heart electrically stimulated at a constant rate, the order of crude negative inotropic potency was: Apr > Qui > Mex > Dis > Lid > Toc, and the order of negative inotropic potency (determined by the ratio: ID 50 for Fc in driven heart/ID 50 for spontaneously beating HR) was: Mex > Apr > Toc > Dis > Qui > Lid ( n = 6). 5. 5. There was a significant influence of negative chronotropic effect on the inotropic potency and the order was: Lid > Qui > Dis > Toc > Apr > Mex. The potency of various drugs is clinically useful in the choice of drugs when considering cardiac function and heart rate.

The effects of hypoxia on the beta-adrenoceptor-mediated slow channel responses of guinea pig ventricular muscle in a potassium-rich (27 mM) solution containing Ba2+ were examined using microelectrode techniques. Isoproterenol produced a small depolarization of the resting membrane and also induced repetitive discharges of action potentials at higher concentrations, mainly due to a beta-adrenoceptor-mediated increase in the slow channel conductance. Two different threshold concentrations of isoproterenol, one for inducing depolarization and one for inducing automatic activity, were measured to assess myocardial responsiveness to catecholamines. During hypoxia, the electrically triggered slow upstroke action potentials of muscle were gradually depressed and catecholamine-induced membrane responses mediated by the beta-adrenoceptor/slow channel system were enhanced. The enhancement of the catecholamine effects was accelerated by acidosis and reversed by reoxygenation. Methyl xanthine-induced responses, similar to those induced by catecholamines, were also enhanced during hypoxia. It is suggested that not only changes of catecholamine-beta-adrenoceptor interaction, but also changes of intracellular metabolic processes, may be responsible, at least in part, for the enhancement of abnormal automatic activity mediated by the myocardial beta-adrenoceptor/slow channel system under hypoxic conditions.

To assess the perfusion reserve of coronary collateral circulation, we analyzed exercise-stress tomographic thallium-201 myocardial images in 12 patients who had total occlusion in the right coronary artery (RCA) or left circumflex coronary artery (LCX) with well-developed collateral circulation and 90% stenosis in the left anterior descending coronary artery (LAD). In 6 of the 12 patients, the collateral circulation was non-jeopardized (group A). In the remaining 6 patients, the collateral circulation was jeopardized (group B). All 6 of the patients in group A had an exercise-induced decrease in thallium uptake in the segments supplied by the occluded RCA or LCX with collateral circulation, and 3 (50%) of these 6 also showed a decrease in thallium uptake in the segments supplied by the LAD. All 6 of the patients in group B also had an exercise-induced decrease in thallium uptake in the segments supplied by the occluded RCA or LCX with collateral circulation, but none showed a decrease in thallium uptake in the segments supplied by the LAD. In conclusion, the perfusion reserve of collateral circulation is equal to or less than 90% stenosis and myocardial ischemia occurs first in the collateralized segments during exercise in patients with jeopardized collateral circulation.

In order to investigate the relationship between sympathetic activity and postexercise systolic blood pressure (SBP) and exercise-induced ventricular arrhythmias in patients with coronary artery disease (CAD), we studied 38 patients and 9 normal subjects who underwent treadmill testing. Peak pressure-rate product was similar in the 2 groups. The plasma concentrations of norepinephrine and epinephrine at rest and immediately after exercise were significantly higher in patients with CAD compared with normal subjects (norepinephrine at rest, p

Polymerization of 1-methylthio-1-alkynes (MeSCCR; R = Et, n-Bu, n-C6H13, and n-C8H17) was studied by use of transition metal catalysts. A 1 : 2 mixture of MoCl5 and Ph3SiH provided polymers having Mw over 1 × 105 in 30–50% yields from these monomers. The length of the alkyl group hardly affected the polymerization. The monomer, MeSCC-n-C6H13, showed low reactivity in homopolymerization, but higher reactivity than that of MeCC-n-C5H11 in copolymerization. Poly(1-methylthio-1-alkyne)s were colorless solids, and those with long alkyl pendants (R = n-C6H13, n-C8H17) were soluble in various organic solvents. The present polymers were thermally more stable than poly(2-alkyne)s, the corresponding hydrocarbon polymers.

Preparation des polymeres de structure (-C(CH 3 )=C(R)S-)n par polymerisation de 1-alkylthio-1-propynes catalysee par le systeme MoCl 5 /Ph 3 SiH dans le toluene Leur masse moleculaire M w atteint 1-2.10 5 , ils sont incolores completement solubles dans les solvants organiques usuels, donnent des films, commencent a se decomposer vers 220°C sont isolants electriques et moderement permeables aux gaz

The effects of a large number of sintering aids for the densification of magnesia were examined. Al2O3, BaO, Fe2O3, P2O5, SiO2, TiO2, Y2O3 and ZrO2 are effective for the sintering of CVD-MgO powders at low doping levels. The effects of TiO2 and ZrO2 are significant. Heavy doping is harmful for densification. The eight oxides above are also effective for the sintering of seawater MgO, but the degree of effectiveness is smaller than for CVD-MgO. In the doping of BaO, P2O5, SiO2 and TiO2, which form eutectic liquids with MgO below 1600°C, there is an optimum firing temperature for densification. Vickers hardness of doped MgO is proportional to the relative density and is unaffected by doping. Corrosion resistance of MgO ceramics for liquid PbO is also unaffected by dopants, except for P2O5.

The incidence of acute hepatitis A infection in Japan peaked 10 years ago and has been decreasing since then. However, an increase in severe cases of the disease has been documented recently. We experienced an outbreak in 1998–1999, and compared the clinical features of the disease in 1998–1999 (recent outbreak) and in 1987–1988 (past outbreak) in our prefecture (Gunma). Forty patients with acute hepatitis A were admitted to nine Gunma hospitals from October 1998 to September 1999. Their clinical features were compared with those of 100 patients with acute hepatitis A admitted to the same hospitals in 1987–1988. Both outbreaks occurred mostly during the winter-spring season. Secondary familial infection was significantly decreased in the recent outbreak. Patients in the recent outbreak were 7 years older than those in the past outbreak. Laboratory findings, such as serum aspartatate aminotransferase (AST) and alanine aminotransferase (ALT) levels and prothrombin time, were worse in the recent than in the past outbreak. Severe-type hepatitis and fulminant hepatitis occurred in 5 patients (12.5%) in the recent outbreak but in only 2 patients (2.0%) in the past outbreak. Clinical data and manifestations were more severe in the recent outbreak than in the past outbreak of acute hepatitis A. It is important to be aware of hepatitis A virus infection and to take into account the available vaccination against hepatitis A virus in Japan.

Summary A case of polypoid tumor of the esophagus consisting of a sarcomatous tumor partly covered with superficial squamous cell carcinoma is described. The sarcomatous component consisted of anaplastic spindle and pleomorphic tumor cells that mimicked malignant fibrous histiocytoma (MFH). Both the sarcomatous and carcinomatous components were positive for p53 immunohistochemically. Further molecular analysis revealed that the two components had the same somatic mutation in the p53 gene. These results suggest a monoclonal origin of this biphasic tumor.

The prevalence of hepatitis G virus (HGV) in liver disease of non-A, -B, -C viral hepatitis, hepatitis B and hepatitis C was determined. Two of 44 patients (4.5%) with liver injury without any hepatitis A, B or C marker were positive for HGV. One of five cases of hepatocellular carcinoma was positive for HGV. One of three cases with fulminant hepatitis was positive for HGV. This case was negative at the onset of fulminant hepatitis and became positive after plasmapheresis. No patient with acute (n=8) or chronic (n=5) hepatitis or liver cirrhosis (n=8) was positive for HGV in non-A, -B, -C liver disease. One of 30 patients with various HBV-positive liver diseases and nine (17.3) of 52 patients with type C liver disease were positive for HGV. In patients with hepatitis C, four (28.6%) of 14 HGV-co-infected patients were complicated with diabetes mellitus compared with four (10.5%) of 38 single hepatitis C virus (HCV)-infected patients (not significant). In 12 HGV-positive patients, eight of 10 (80%) had a history of blood transfusion. In HCV-positive patients, co-infection with HGV was not a risk factor in patients with diabetes mellitus as a complication. HGV appeared to cause non-A, -B, -C hepatitis rarely, and its main route of infection was blood transfusion.

We report a 66-year-old man with hepatocellular carcinoma who was positive for hepatitis B surface antigen, and was hospitalized because of hypoglycemia and hypertension. His plasma renin activity was normal (2.3 ng/ml per h), but concentrations of angiotensin I (>2500 pg/ml) and II (86 pg/ml) were high. Increased angiotensin I level at sites proximal and distal from the confluence of the hepatic vein and the inferior vena cava indicated that the hypertension was provoked by overproduction of angiotensin I from the hepatocellular carcinoma. Previous reports of patients with hepatocellular carcinoma with hypertension due to abnormality of renin-angiotensin system are reviewed.

Accidental transmission of contagious pathogens, especially hepatitis C virus (HCV), by needlestick or other means as an occupational hazard for medical staff is of concern. We retrospectively analysed cases of work-related accidental injury with pathogens such as hepatitis B virus (HBV), HCV, syphilis and human immunodeficiency virus (HIV) reported to the centres for disease control at 15 hospitals (total 5776 beds) in the Gunma prefecture, Japan, from December 1990 to August 1993 (24.7 months). There were 416 such cases (16.8 cases/month), with an incidence of 0.2-3.5 accidents per month per hospital. Such accidents occurred in 297 (71.2%) nurses, 98 (23.5%) medical doctors, 13 (3%) laboratory technicians, four (1.0%) hospital maintenance workers, one (0.2%) assistant nurse, one secretary and two others. There were 323 (77.6%) injuries caused by needlestick, 42 (10.1%) from suture needles or surgical knife cuts, 17 (4.1%) from blood splatters from patients into the eyes or mouth, 10 (2.4%) from contact with injured skin and 24 (5.8%) simple skin contacts. Of the pathogens, 60.3% were HCV, 22.6% HBV, 5.8% syphilis, 0.7% HIV and 10.6% were of unknown origin. Four cases (1.6%) of HCV infection were found and treated with one or two courses of interferon therapy, and HCV was subsequently cleared. All four patients were cured with interferon therapy. None of the HBV-injured cases resulted in infection, possibly because of prophylaxis with HB immunoglobulin and HB vaccine. No HIV or syphilis infection was contracted. In summary, chronic HCV infection acquired as an occupational hazard can be cured by appropriate treatment, such as with interferon, after early detection of the infection.

To elucidate the effect of Nicorandil on myocardial energy metabolism and myocardial sympathetic activity, we administered Nicorandil orally to eight patients with angina pectoris prior to exercise testing. Arterial and coronary sinus levels of lactate, ammonia, hypoxanthine (HX), adrenaline and noradrenaline were measured during exercise in order to determine the irrespective myocardial extraction ratios (MER). Compared to placebo, Nicorandil increased the time to development of significant ST depression (322 vs 390 s) while decreasing the maximum amplitude of ST depression (0.244 vs 0.216 mV). Heart rate, systolic blood pressure, and the rate pressure product during exercise were not significantly affected. The MER of lactate, measured during exercise, was significantly higher after Nicorandil than placebo (13.6 vs 27.9). Similarly, the MERs of ammonia and HX were significantly higher after Nicorandil (-46.0 vs 7.4% and −47.0 vs 9.9% respectively). Nicorandil, had no apparent effect on myocardial sympathetic activity as the MERs of adrenaline and noradrenaline were essentially unaffected. We conclude that Nicorandil decreased myocardial ischaemia and suppressed myocardial accelerated purine metabolism (a marker of cellular energy metabolism) during exercise in patients with angina pectoris. This effect appears not to be related to myocardial sympathetic activity.

— To understand actual viewing conditions at home is important for TV design. And the preferred luminance level of LCD TVs under actual viewing conditions is also important in order to obtain both good picture quality and low power consumption. The actual viewing conditions of households and the preferred luminance levels was investigated. In a field test of 83 households, the display luminance, screen illuminance, and viewing locations were measured on site. In laboratory experiments, young and elderly subjects adjusted the luminance of an LCD-TV screen to their preferred levels under different screen illuminance levels, angular screen sizes, and average luminance levels (ALL) of the images. As a result, two equations, which represent the preferred luminance level of LCD-TV screens corresponding to different viewing conditions for young and elderly subjects were obtained. When the ALL of the images was 25% and the screen illuminance and angular screen size were set at 100 lx and 20°, respectively, the preferred luminance was 1 60 cd/m2 for the young subjects and 248 cd/m2 for the elderly subjects. By using the setting of the preferred luminance of an LCD TV under actual viewing conditions, it is possible to conserve energy consumption.

1. 1. Hemodynamic responses to Bunazosin (BZN) in congestive heart failure (CHF) were evaluated for 6 hours (hr) in 30 patients (A, normal cardiac function; B, mild cardiac dysfunction; C, severe cardiac dysfunction). 2. 2. For 6 hr after BZN, the increments of cardiac index (Δ CI) and stroke volume index (Δ SVI) with BZN were higher in groups A and B than in group C. 3. 3. A significant positive correlation was observed between ejection fraction and maximum Δ CI and SVI, and between % fractional shortening and maximum Δ CI and SVI. 4. 4. These data showed that BZN improved the hemodynamics of CHF patients and that patients in groups A and B responded well to this vasodilator, however, patients in group C did not.

To investigate the effects of volume and pressure overloads and myocardial hypertrophy on exercise-induced changes in QRS amplitude, we reviewed treadmill exercise electrocardiograms. In 10 normal young men, Rv5 amplitude decreased and Sv1 amplitude increased at peak exercise, and returned to the resting value in the recovery period. In 10 patients with aortic regurgitation, Rv5 and Sv1 amplitudes increased after 5 min of recovery. In 12 patients with essential hypertension and 10 with idiopathic hypertrophic non-obstructive cardiomyopathy, Rv5 amplitude remained unchanged or higher at peak exercise compared with the resting value, but patterns of serial changes were similar to that of normal subjects. In 9 patients with atrial septal defect, R'v1 amplitude increased with exercise, whereas it remained unchanged in 12 with isolated complete right bundle branch block. In 5 patients with mitral stenosis, Sv1 amplitude decreased at peak exercise. In conclusion, changes in QRS amplitude with exercise are influenced by hemodynamic abnormality and myocardial hypertrophy, and a major determinant of these serial changes seems to be the change in ventricular volume.

We assessed blood pressure and neurohumoral factors at rest and during exercise in 10 patients with essential hypertension before and after treatment with the new angiotensin converting enzyme inhibitor, alacepril (25-50 mg day-1). Alacepril significantly lowered mean blood pressure at rest and at the same exercise load as before treatment without affecting heart rate response. The response of plasma renin activity, plasma aldosterone, and plasma adrenaline were not changed by alacepril, but increase of plasma angiotensin II and plasma noradrenaline during exercise were significantly attenuated after alacepril treatment (ANOVA, P = 0.04, both). The change in mean blood pressure during exercise was positively correlated with the decrease in plasma angiotensin II (r = 0.65, P < 0.05). These results demonstrated that alacepril was effective in essential hypertension both at rest and during exercise, suggesting that the antihypertensive effect during exercise might be related to the decrease in pressor hormones, especially in plasma angiotensin II.

1. 1. Treadmill testing was done and plasma epinephrine and norepinephrine were measured during exercise and recovery in 21 patients with coronary artery disease given nicorandil. 2. 2. Epinephrine levels during exercise did not change significantly with nicorandil, but the percent change in epinephrine with nicorandil tended to be lower during exercise. 3. 3. Norepinephrine levels after exercise were suppressed with nicorandil (with, 424 ± 15 pg/ml; without, 760 ± 16, P < 0.05). 4. 4. Also, the percent change in norepinephrine with nicorandil was significantly decreased during exercise and recovery (with, 259 ± 11%; without, 555 ± 19, P < 0.01). 5. 5. Therefore, nicorandil suppressed the sympathetic nervous system hyper-response to exercise.

We have developed a new display / video camera and wide-gamut characterizing tools for a new standard for extended-gamut YCC color space called xvYCC. Video systems adapting this standard will have improved accuracy of color reproduction of real world.

Background It is reported that there maya link between abnormal catecholamine metabolism and hyperthropic cardiomyopathy (HCM). However, there are controversies about plasma catecholamine levels in patients with HCM. Studies were limited about serial measurements in plasma catecholamine during exercise. This study determined if cardiovascular and plasma catecholamine responses to exercise were altered in HCM. Methods 17 patients with HCM (15 male, 2 female, mean age: 54 ± 2) and 17 age-sex matched controls were evaluated by submaximal treadmill exercise test using Bruce protocol. Plasma norepinephrine (NE) and epinephrine (E) were measured at rest, at the end of each stage during exercise and immediately after exercise. Results Exercise duration was shorter in HCM (Control vs HCM: 11.2 ± 0.6 vs 8.7 ± 0.6 min, p l 0.01). Mean blood pressure were higher at stage I (100 ± 10 vs 109 ± 3mmHg, p l 0.05) and at stage II (101 ± 3 vs 112 ± 3 mmHg, p l 0.01) in HCM. Resting NE levels (151 ± 15 vs 168 ± 23 pg/ml, n.s.) were not different. but NE at stage I (253 ± 25 vs 400 ± 57 pg/ml, p l 0.05) and at stage II (314 ± 31 vs 550 ± 89 pg/ml, p l 0.05) were significantly higher in HCM. Peak NE levels (534 ± 52 vs 724 ± 102 pg/ml, n.s.) were insignificantly higher in HCM. Heart rate response was similar in both groups, but the ratio of the increment in heart rate divided by the increment in NEat stage I (0.47 ± 0.09 vs 0.17 ± 0.03, p l 0.01) and at stage II (0.37 ± 0.05 vs 0.20 ± 0.04, P l 0.05) were significantly less in HCM. There were no difference in E responses during exercise in both groups. Conclusion Patients with HCM had augmented plasma NE levels during submaximal treadmill exercise test with higher blood pressure response compared to controls. In addition, chronotropic sympathetic responsiveness was impaired in patients with HCM.

An autopsy case of diabetic nephropathy is reported. The patient, a 70-year-old woman, died of uremia caused by diabetic glomerulosclerosis. Histopathologically, the islets of the pancreas demonstrated amyloidosis. Microscopic findings of the kidneys showed glomerulosclerosis. Electron micrographs revealed thickening of the basement membranes of glomeruli, Bowman's capsules, and renal proximal tubules. The lungs demonstrated uremic pneumonitis microscopically. The diabetic renal changes were supposed to be caused by metabolic alteration of basement membranes.

1. The effects of nizofenone fumarate were studied on the membrane potentials and currents of rabbit sino-atrial node preparations by means of the double-microelectrode voltage clamp method. 2. In spontaneously firing pacemaker cells, nizofenone (above 1 microM) decreased the heart rate. Above 3 microM, nizofenone reduced the maximum upstroke velocity, the amplitude of the action potential and the slope of the phase 4 depolarization, and prolonged the action potential duration at 50% repolarization. 3. Under voltage clamp conditions, nizofenone decreased the slow inward current and the time-dependent potassium outward current in a dose-dependent manner. 4. These findings suggest that nizofenone exerts an inhibitory action on the automaticity of sinoatrial node preparations via effects on both inward and outward currents.

Electrophysiological effects of ketanserin on pacemaker activity of rabbit sinus node cells were studied using double-microelectrode voltage clamp method. Ketanserin (10(-5) mol/l) caused an increase in spontaneous cycle length accompanied by decreases in the maximum upstroke velocity of the action potential, the slope of the phase 4 depolarization and the action potential amplitude. On the current systems, ketanserin reduced the slow inward current (Isi) and the time-dependent potassium outward current (IK) in a dose-dependent manner. As for a decrease in the outward current, the agent did not change the steady-state activation of IK. These observations indicate that ketanserin does not have a specific effect on a single current system, but that the drug exerts an inhibitory effect on the electrical activity of the sinus node pacemaker cells.